Open Access
Pulmono-atrial shunt and lung assist to treat right ventricular failure
Jan Spillner1,Andrea Amerini1,Nima Hatam1,Steffen Rex1,Frank Pott1,Andreas Goetzenich1,Ares Menon1,Thorsten Repas1,Frederik Steiner1,Rüdiger Autschbach1,Angelo Carpi1,Oliver Oster1
Clinic for Cardiothoracic Surgery, University Hospital RWTH Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany.
DOI: 10.2741/3857 Volume 16 Issue 6, pp.2342-2351
Published: 01 June 2011
(This article belongs to the Special Issue Advances in bone disease pathophisiology and management)

In right ventricular failure (RVF) a decrease of right ventricular afterload and improvement of left atrial filling could be achieved by a pulmonary artery-left atrial (PA)-shunt. To avoid cyanosis, artificial oxygenation is necessary. In 11 pigs a PA-shunt was created. An interventional lung assist device (ILA) was installed from the femoral artery to vein in 5 pigs (serial in relation to native lung: Group I) and into the PA-shunt in 6 pigs (parallel: Group II). RVF was induced by pulmonary artery banding. Right ventricular performance was determined by pulse contour analysis, pressure - and flow measurements. In both groups a stable RVF was generated. In Group I cardiac output trended to increase but neither right ventricular filling pressures nor arterial pressure changed significantly. The PaO2 decreased significantly. In Group II cardiac output and arterial pressure increased significantly under a shunt flow of 2.3- 2.6 l/min and the animals recovered from cardiogenic shock. In conclusion a PA-shunt with a parallel lung assist can effectively reverse the deleterious effects of RVF.

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Jan Spillner, Andrea Amerini, Nima Hatam, Steffen Rex, Frank Pott, Andreas Goetzenich, Ares Menon, Thorsten Repas, Frederik Steiner, Rüdiger Autschbach, Angelo Carpi, Oliver Oster. Pulmono-atrial shunt and lung assist to treat right ventricular failure. Frontiers in Bioscience-Landmark. 2011. 16(6); 2342-2351.